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Research Article| Volume 100, ISSUE 2, P215-221, May 2013

Gestational diabetes in a multiethnic population of Spain: Clinical characteristics and perinatal outcomes

Published:March 27, 2013DOI:https://doi.org/10.1016/j.diabres.2013.01.030
Gestational diabetes in a multiethnic population of Spain: Clinical characteristics and perinatal outcomes
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      Abstract

      Aims

      To compare clinical characteristics and perinatal outcomes between immigrant and Spanish women with gestational diabetes mellitus (GDM) in a multiethnic population of Barcelona and to identify factors independently associated with the development of large-for-gestational-age (LGA) infants.

      Methods

      Prospective study of women with GDM from five ethnic groups (Caucasian, South-Central Asian, Latin American, East Asian and Moroccan) at a single institution in Barcelona between 2004 and 2011. Maternal, gestational and newborn characteristics were recorded.

      Results

      The cohort included 456 patients. In univariate analyses, Moroccan women had more frequently a pre-gestational body mass index (BMI) > 25 kg/m2 (76.4%, P = 0.012), while East Asian women had lower BMI (23.41 ± 2.79 kg/m2, P < 0.001), less need for insulin therapy (14.3%, P = 0.013) and the highest rate of spontaneous labor (69.8%, P = 0.014) and eutocic delivery (63.8%, P = 0.032). Also, Latin American women had a higher rate of Cesarean section (52.9%, P < 0.001) and LGA infants (28.6%, P = 0.004), and their newborns had lower umbilical cord pH (7.23 ± 0.06, P = 0.005) and Apgar scores (9 [
      • HAPO Study Cooperative Research Group
      • Metzger B.E.
      • Lowe L.P.
      • Dyer A.R.
      • Trimble E.R.
      • Chaovarindr U.
      • et al.
      Hyperglycemia and adverse pregnancy outcomes.
      N Engl J Med. 2008; 358: 1991-2002
      ,
      • Crowther C.A.
      • Hiller J.E.
      • Moss J.R.
      • McPhee A.J.
      • Jeffries W.S.
      • Robinson J.S.
      Effect of treatment of gestational diabetes mellitus on pregnancy outcomes.
      N Engl J Med. 2005; 352: 2477-2486
      ,
      • Xiang A.H.
      • Li B.H.
      • Black M.H.
      • Sacks D.A.
      • Buchanan T.A.
      • Jacobsen S.J.
      • et al.
      Racial and ethnic disparities in diabetes risk after gestational diabetes mellitus.
      Diabetologia. 2011; 54: 3016-3021
      ,
      • Hedderson M.M.
      • Darbinian J.A.
      • Ferrara A.
      Disparities in the risk of gestational diabetes by race-ethnicity and country of birth.
      Paediatr Perinat Epidemiol. 2010; 24: 441-450
      ,
      • Savitz D.A.
      • Janevic T.M.
      • Engel S.M.
      • Kaufman J.S.
      • Herring A.H.
      Ethnicity and gestational diabetes in New York City, 1995–2003.
      BJOG. 2008; 115: 969-978
      ,
      • Hunsberger M.
      • Rosenberg K.D.
      • Donatelle R.J.
      Racial/ethnic disparities in gestational diabetes mellitus: findings from a population-based survey.
      Womens Health Issues. 2010; 20: 323-328
      ,
      • Kim C.
      • Berger D.K.
      • Chamany S.
      Recurrence of gestational diabetes mellitus.
      Diabetes Care. 2007; 30: 1314-1319
      ], P < 0.01) and a higher incidence of neonatal hypoglycemia (51.4%, P = 0.045). Logistic regression analysis identified pre-gestational BMI (OR: 1.18; 95% CI: 1.09–1.27), pregnancy weight gain (OR: 1.19; 95% CI: 1.1–1.28) and insulin use during gestation (OR: 2.29; 95% CI: 1.09–4.82) as predictors of LGA infants.

      Conclusions

      Significant ethnic differences were found in clinical characteristics and perinatal outcomes of women with GDM. Latin American women had a higher frequency of adverse perinatal outcomes. Pregestational BMI, pregnancy weight gain and insulin use during pregnancy were independent predictors of LGA.

      Keywords

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      Article info

      Publication history

      Published online: March 27, 2013
      Accepted: January 25, 2013
      Received in revised form: December 14, 2012
      Received: August 23, 2012

      Footnotes

      ☆Preliminary findings of the submission were presented at the 6th International Symposium on Diabetes and Pregnancy held in Salzburg, Austria, March 23–26, 2011.

      Identification

      DOI: https://doi.org/10.1016/j.diabres.2013.01.030

      Copyright

      © 2013 Elsevier Ireland Ltd. Published by Elsevier Inc. All rights reserved.

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